Samantha Jo Dates
Samantha Jo Dates is a Licensed Practical Nurse in Randolph, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2020.
- Licensed in
- WI
- In the registry since
- 2020
Practice location Address checks out
N8273 E Friesland RdRandolph, WI 53956-9407
Phone: (920) 296-7067
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Licensed Practical Nurse (primary) | Taxonomy 164W00000X · Licence 325608 (WI) |
|---|
Record details
| NPI number | 1538767355 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | October 14, 2020 |
| Last updated in NPPES | October 14, 2020 |
| Certification date | October 14, 2020 |
| Mailing address | N8273 E Friesland Rd, Randolph, WI 53956-9407 |